Laserfiche WebLink
Burnett County 7410 Co. Rd.K, No. 102, Siren,WI 54872 Office of Zoning Administrator d 0 0 <br /> APPLICATION FOR LAND USE PERMITS w <br /> 2 0 <br /> TO THE ZONING ADMINISTRATOR: The undersigned hereby makes application for a Permit for the work <br /> described and located as shown herein. The undersigned agrees that all work shall be done in accor- <br /> dance with the requirements of the Burnett County Land Use Ordinance,Sanitation Code,and with all other - o <br /> applicable County Ordinances and the laws and regulations of the State of Wisconsin. 7a77_ 79(<Oy <br /> OWNER TELEPHONE Z2 Q m <br /> 1 �' / z�o� <br /> m <br /> HOME ADDRESS .S —> Vr�3 O �� L <br /> EMERGENCY/FIRE NUMBER U -3 v F3 ROAD NAME �= J <br /> J J � <br /> LEGAL DESCRIPTION(see tax receipt) <br /> CONTRACTOR O <br /> ig o <br /> TYPE OF PERMIT(S): DWELLING/BUILDING GARAGE/ACCESSORY STRUCTURE ADDITION <br /> N ti <br /> O Pi <br /> SANITARY PRIVY FILLING/GRADING CAMPING UNIT SUBDIVISION <br /> l/ �� . G�� // Z 7 �Z�r e <br /> STRUCTURE/ADDITION USE: nth � <br /> J <br /> (Home/Cabin; Commercial Business; Bedroom; Deck;etc.) -� <br /> r <br /> 0 <br /> A PLOT PLAN MUST BE PROVIDED ON A SEPARATE SHEET OF PAPER, ANY INCOMPLETE OR <br /> ILLEGIBLE PLOT PLANS WILL BE RETURNED. In <br /> O <br /> DIRECTIONS FOR PLOT PLAN DRAWING: (Aerial or top view) p 3 <br /> -n P fn <br /> 1. All required dimensions or distances to be shown or drawn to scale. n o a <br /> 2. Show the location and size of all existing buildings (EB)and all new buildings(NB) and indicate m y: <br /> North (N). y ° <br /> 3. Show dimensions in feet of the following: (a) building(s)to all lot lines, (b) building(s)to centerline of In <br /> road, (c) building(s) measurement to the ordinary high water mark (OHWM)of lake, stream or river. s <br /> 4. Show the location of the well (W), septic tank(ST)and drainfield (DF), and all distances to buildings, <br /> roads, lake, lot lines. W <br /> 5. Indicate if a walkout basement is planned and show areas to be graded or filled. (j <br /> 6. If separate plans are submitted by an architect, engineer, builder, contractor, etc., the plans must be SiJ <br /> signed and dated by the owner. v <br /> G 2 <br /> NOTE: BUILDING/STRUCTURE LOCATIONS MUST BE STAKED FOR ONSITE VERIFICATION BE- <br /> FORE A PERMIT CAN BE ISSUED. <br /> N <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW. V <br /> CONDITIONS OF PERMIT: o <br /> N <br /> 1. DRIVEWAY MUST MEET DRIVEWAY WIDTH REQUIREMENTS WITHIN 60 DAYS OF PERMIT <br /> ISSUANCE. <br /> 2. REMOVAL OR CUTTING OF TREES AND VEGETATION IS RESTRICTED ALONG SHORELINE. <br /> 3. NO GRADING OR SHORELAND ALTERATIONS ARE ALLOWED UNLESS SPECIFICALLY p <br /> PERMITTED. <br /> 4. NO STRUCTURES, INCLUDING RETAINING WALLS, ETC., ALLOWED WITHIN 75 FEET OF THE <br /> OHWM OF LAKES, PONDS, RIVER UNLESS SPECIFICALLY PERMITTED. / f <br /> 5. f peJ/n,fi yat6�c T FFti) 07)' S f q f2 Qi e ✓l �rmr <br /> 6. PrpP ro, 3. l <br /> tornvrn DD <br /> M 0a M. 0 8 £ m <br /> g.� R33 <br /> 7. a < � : -2mo � o <br /> 9 f T� <br /> 8. o =NE m <br /> m <br /> o E c C <br /> I declare that this application (Including an accompanyingschedule has been examined b me and to the best of m <br /> PP ( 9 Y ) Y Y m <br /> knowledge and belief It is true,correct and complete. I acknowledge that I am responsible for the detail and accuracy of E <br /> all information contained In this application(including any accompanying schedule)and I further declare that I recognize o o <br /> that this Information I am providing will be relied upon by the County of Burnett Wisconsin in determining whether to is- <br /> sue a permit. 1 further accept all liability which may be a result of the County of Burnett retying on this Information I am p [ <br /> providing In this application. I agree to permit county officials charged with administering county ordinances or other ? 3 8 [ <br /> authorized person to have access to the above described premises at any reasonable time for the purpose of Inspection. T i w E <br /> x <br /> SIGN HERE <br /> 01injifture of ow or building contractor) <br /> ZONING ADMINISTRATOR I '• '• � ' ' <br /> -n <br /> TOWNSHIP PERMITS MAY BE REQUIRE l h i .AL 15 <br /> 0000ggoo f/1 <br />